Claims Processor
$17.5 - $22.5 per hourCynet Systems
Job Overview:
Pay Range: $17.50hr - $22.50hr
Requirement/Must Have:
Pay Range: $17.50hr - $22.50hr
Requirement/Must Have:
- High School diploma or equivalent work experience.
- 3+ years of data entry experience.
- Strong customer service focus.
- Strong verbal and written communication skills.
- Ability to multi-task and prioritize issues.
- Strong attention to details.
- Efficiently and accurately processes a variety of vision insurance claims or adjustments.
- Determines any special plan requirements prior to billing.
- Reviews claims before entry for completeness and compliance with business requirements.
- Effectively and accurately reviews images and transcribed data in the portal in preparation for auto adjudication.
- Coordinate and complete claim error corrections.
- Maintains the Medicare/Medicaid Pend Claims process.
- Participates on special project initiatives, including rework efforts as needed.
- Understands and quickly operationalizes processing changes resulting from new plans, benefit designs.
- Maintains compliance with HIPAA guidelines and regulations.
- Works with supervisor and co-workers to provide strong customer service and communication with key customer interfaces that include Account Managers, Operations, Information Systems, Client Representatives and leadership team.
- Assists Team Lead in a backup lead capacity.
- Assists with root cause analysis of claim issues to resolve thoroughly and completely for clients.
- Contacts stores or providers (when necessary) to obtain additional information or follow up on claims.
- Knowledge of Medicare/Medicaid business.
- Knowledge of vision benefits and/or insurance industry.
- Proficient in Microsoft Word, Excel and Access.
- Data Entry.
- Claims Processing.
- HIPAA Compliance.
- Microsoft Word.
- Microsoft Excel.
- Microsoft Access.
- Customer Service.
- Root Cause Analysis.
- High School diploma or equivalent work experience.
Vacancy posted 5 days ago
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